Serial ctDNA analysis predicts clinical progression in patients with advanced urothelial carcinoma
Menée à partir du séquençage ciblé de 182 ADN tumoraux circulants provenant de 53 patients atteints d'un carcinome urothélial de stade avancé, cette étude met en évidence l'intérêt de mesurer l'évolution de la fréquence allélique d'altérations génomiques pour prédire la progression de la maladie
Background : Targeted sequencing of circulating tumour DNA (ctDNA) is a promising tool to monitor dynamic changes in the variant allele frequencies (VAF) of genomic alterations and predict clinical outcomes in patients with advanced urothelial carcinoma (UC).
Methods : We performed targeted sequencing of 182 serial ctDNA samples from 53 patients with advanced UC.
Results : Serial ctDNA-derived metrics predicted the clinical outcomes in patients with advanced UC. Combining serial ctDNA aggregate VAF (aVAF) values with clinical factors, including age, sex, and liver metastasis, improved the performance of prognostic models. An increase of the ctDNA aVAF by
≥
1 in serial ctDNA samples predicted disease progression within 6 months in 90% of patients. The majority of patients with aVAFs
≤
0.7 in three consecutive ctDNA samples achieved durable clinical responses (
≥
6 months).
Conclusions : Serial ctDNA analysis predicts disease progression and enables dynamic monitoring to guide precision medicine in patients with advanced UC.
British Journal of Cancer , résumé, 2022